Study attacks racial disparities in cancer with exercise

Alice Yan, an associate professor in UWM's Zilber School of Public Health, is studying whether exercise and other factors can help reduce the racial disparity in breast cancer survival rates. (UWM Photo/Elora Hennessey)

Alice Yan knows that beating breast cancer takes more than good medical care: It takes a community of like-minded women determined to live a healthier lifestyle.

Yan, an associate professor of community and behavioral health promotion at the Joseph J. Zilber School of Public Health, recently finished a four-week group exercise program with 12 African-American breast cancer survivors. The program is part of a two-year cancer survivorship study funded by the American Cancer Society. The study aims to address significant racial disparities in breast cancer outcomes in the United States.

“African-American women have a 23 percent lower five-year relative survival rate than their white counterparts,” Yan said. “Research has shown that exercise plays a vital role in improving the lives of breast cancer survivors. Even brisk walking can be beneficial.”

Unfortunately, many breast cancer survivors do not have an active lifestyle. The next step, then, was supporting African-American women cancer survivors in making exercise part of their lifestyle.

A key element in accomplishing this research study was community participation. Yan partnered with the Black Health Coalition of Wisconsin to develop the exercise program, which was conducted at the Martin Luther King Community Center on North 16th and West Vliet streets.

The first part of Yan’s study involved focus groups in which the women identified culturally relevant and contextual factors that presented barriers to exercise, as well as those that would enhance the likelihood that they would participate in exercise on a regular basis.

“One thing we saw was that it was important that the programs be offered where the women live, work and socialize,” Yan said.

The community involvement helped ensure that the program had a culturally sensitive design.

“So, for example, the participants are very spiritual, very religious, and they concluded their exercise session with group prayer, very often expressing gratitude for the strength — both physical and moral — to participate.”

Yan also feels the group setting is another factor that will help the women motivate each other to continue after the study is over.

In August, the project is expanding to include 45 women. This phase includes a self-management component to help participants better manage treatment or cancer-related side effects or symptoms such as nerve pain, tiredness and joint pain. In addition to exercise programming, this project will also provide guidance on nutrition to mitigate comorbidities — obesity, cardiovascular disease and Type 2 diabetes — that exacerbate those health effects.

Now roughly halfway through the study, Yan has come to know and admire the participants. And she’s come to appreciate their fortitude.

“I’ve learned a lot about their faith, their hope and purpose of life — factors that motivate these women to survive,” Yan said. “One is their religious faith. Another is their inner strength and resilience.

“They are strong black women. Their stories are inspiring to me. In the midst of their darkest hours, these women decided to opt for a fighter mentality instead of a defeated one. To them, life was worth fighting for, as it’s a precious gift from God. They’ve been through a lot, but they are still so committed to supporting their families and neighbors — people who rely on them.”

Lisa Goodwin, a five-year cancer survivor and a lay-health adviser for the project, said she found the program helpful for her neuropathy, but also good for her mind and spirit.

She pointed out that the impact on the women has continued even after their participation was finished.

“Some of the ladies in the group called me, and we’ve started getting together to work out on our own,” Goodwin said.

Yan hopes to build on this current two-year study with a five-year study that has a broader geographical reach.